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Extended Lymphadenectomy in Colon Cancer Is Debatable

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Abstract

Extended lymphadenectomy has gained considerable attention as an adjunct to conventional colon cancer surgery with the hope that it may potentially decrease local recurrence rates and improve cancer-specific outcome measures. Despite the enthusiasm surrounding these techniques, it is difficult to establish any additional survival benefit associated with more comprehensive lymphadenectomy strategies when these are performed in addition to conventional colon cancer surgery. Furthermore, these techniques remain unproven by large randomized clinical trials. The appropriate indications for performing extended lymphadenectomy also remain unclear, and there is a lack of standardization with regard to surgical technique. Moreover, there are a number of confounding factors that frequently receive little attention when oncological outcome measures are reported following extended lymphadenectomy in the setting of colon cancer. The purpose of this review is to outline these confounding issues and discuss their impact on reports describing cancer-specific outcome measures following the use of extended lymphadenectomy techniques. Furthermore, this review proposes that in light of the available published evidence, the role of radical lymphadenectomy is currently unproven, with large randomized clinical trials required in the future to determine whether there is a survival benefit for colon cancer patients.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Mayo Clinic, 5777 E. Mayo Boulevard, Phoenix, AZ, 85054, USA

    Jamie Murphy & Tonia Young-Fadok

  2. Academic Surgical Unit, Centre for Digestive Diseases, The Royal London Hospital, Whitechapel, London, E1 1BB, UK

    Jamie Murphy

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Correspondence to Jamie Murphy.

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Murphy, J., Young-Fadok, T. Extended Lymphadenectomy in Colon Cancer Is Debatable. World J Surg 37, 1799–1807 (2013). https://doi.org/10.1007/s00268-013-2071-0

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